Frontline Friday round-up 29th March 2013

Michael Harris /   June 29, 2015 at 8:33 PM 1,677 views

Here’s our round-up of frontline blogs we’ve particularly liked from the week of 25th March 2013. Let us know which posts we’ve missed and which other bloggers we should be following for next week’s round-up. This week, the rights and wrongs of online anonymity for health practitioners – but who’s really hiding in the shadows? Teresa Chinn, a registered nurse and the founder of #WeNurses, the Twitter community for nurses, wrote for the NHS Leadership Academy this week about the ‘courage to lead in social media‘: “Just three years ago, I was an agency nurse who felt isolated from the nursing profession to the extent that I almost stopped nursing altogether. I then found a space where I could share ideas, experiences, nursing expertise and facilitate and encourage other nurses to do the same… I never really saw myself as a leader; nursing leaders are traditionally formally appointed by a higher authority… [but] Someone once told me that all nurses are leaders and sometimes we just have to have the courage to rise to the challenge. Looking at the challenges I have faced, I can see that courage has played a huge part. For me it has always been the courage that has been my nemesis – once I found the courage to step up, I could then share my value, vision and direction with others.” Online anonymity is often an important protection for those at the frontline, among other things so that they can express their views on policy matters freely. This week, Zarathustra writing on The Not So Big Society considered the rights and wrongs of anonymity with particular reference to health professionals: “As well as being accountable, there’s also the matter of taking credit for what you’ve done well. There are pitfalls in social media, and if I’m honest with myself I think it’s fair to say I’ve made some mistakes along the way. But there’s also things I’m proud of, such as exposing the shocking lack of regulation in the psychotherapy industry. I’m also proud of helping create and maintain the regular This Week in Mentalists round-ups, in which bloggers take it in turns to tell us about their favourite online mental health writing. I’m proud of the #TwentalHealthAwards that I started this year.” And with that, Zarathustra ‘came out’ (as Philip Doré). Unfortunately, official thinking has been heading in the other direction. As we’ve noted in previous posts on Guerilla Policy (for example, in policing and probation), pressure has been mounting on frontline practitioners to limit their activity on social media. Now it’s the turn of healthcare. This week the General Medical Council published an updated version of its Good Medical Practice, which included supplementary explanatory guidance on the use of social media. This is far from a marginal issue, with more than a third of health practitioners using Facebook on a daily basis and more than a fifth on Twitter (according to a recent survey conducted by the Medical Protection Society). One line in the final version of the guidance has received a lot of attention: “If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name”, on the basis that any material written by authors who represent themselves as doctors may be taken to represent the views of the profession more widely. As Anne Marie Cunningham, a GP and Clinical Lecturer at Cardiff University, noted on her blog Wishful Thinking in Medical Education, the draft version published last year was more flexible, suggesting that those writing in a ‘professional capacity’ should ‘usually identify [themselves]’. Anne contrasted the GMC’s guidance with the social media highway code published by the Royal College of General Practitioners last week, which suggested as a general principle that doctors should use their professional name online if portraying themselves as a registered doctor, but that use of a pseudonym might be reasonable in some circumstances (for example, when writing about a sensitive subject or when being satirical). As Anne identified, the GMC’s guidance leaves a number of questions hanging: “What happens if a doctor is currently tweeting under a pseudonym and does not start using their real name before April 22nd when the guidance is enacted? Will they be disciplined or reported? How will the GMC respond? Usually most doctors are confident that they are working within the bounds of good medical practice but this is making some with existing pseudonymous twitter accounts, or blogs, feel uncomfortable. They are now deciding what steps they should take.” Dr Grumble noted the many comments that Anna has received to her posts on this issue, including a comment from one doctor (‘JG’) made at the time of the draft version of the GMC’s guidance, that points out some of its problems: “Is moaning about the GMC or Mr Lansley’s policies operating in a professional capacity or do they just mean things related to patient care? And if I used my real name wouldn’t that be inviting patients to contact me in my area of special expertise (which I hope I have kept largely under wraps)? That’s not something I want to do and, it would seem, nor should I.” Ironically, this was the same week in which the Government responded to the Francis report into Mid-Staffordshire by setting out plans for an end to the confidentiality clauses which silenced whistleblowers and the introduction of a legal ‘duty of candour’ for hospital boards. As Jim Brown from On Probation Blog noted: “Part of my problem is I’m finding it very hard indeed to reconcile the new wave of ‘openess and transparency’ being espoused by government with quite blatant bullying of people who dare to tell stories that are ‘off message’. The situation is becoming somewhat surreal I feel with the recent announcement of a legal obligation of ‘candour’ within the NHS. WTF does that mean exactly?! “ Meanwhile, The Jobbing Doctor focused on what he saw as a broader agenda at work in the Government’s on-going health reforms: “The ultra-marketeers in the Department of Health have now moved on to another target. Having successfully introduced a market into the NHS where one was not needed, and indeed will be proven to be wasteful and inefficient, they are now questioning the very role and position of General Practice and Primary Care.” The Cockroach Catcher has been reading the 2010 book ‘The Shadow Elite‘ by Janine Wedel and felt a connection with the health reforms: “The new breed of players,” writes Wedel, “who operate at the nexus of official and private power, cannot only co-opt public policy agendas, crafting policy with their own purposes in mind. They test the time-honored principles of both the canons of accountability of the modern state and the codes of competition of the free market. In so doing, they reorganize relations between bureaucracy and business to their advantage, and challenge the walls erected to separate them. As these walls erode, players are better able to use official power and resources without public oversight.” That’s a spot-on description of what happened with health care…” Talking of people who hide in the shadows, far away from the frontline and away from health there has been increasing pressure on @toryeducation this week. Those behind the Twitter account that styles itself as the ‘Pantomime villain of leftie education folk’ (there have been suggestions that government special advisers have been involved), accused the widely-respected Conservative MP and former children’s education minister @timloughton of lying over a serious case review into children’s services in Doncaster. According to briefings by allies of education secretary Michael Gove to the Spectator magazine in January, Loughton was keen to prevent the publication of serious case reviews because he wanted to “maintain a culture of secrecy“, something Loughton strongly denies. Meanwhile, those behind @toryeducation remain umasked – for the moment. We’re always interested in hearing from frontline bloggers, so if you’re interested in having your post featured on Guerilla Policy then do get in touch: [email protected]

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